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Dynamic changes in the hypothalamic-pituitary-adrenal axis during growth hormone therapy in children with growth

Limin Wang, Qian Wang, Guimei Li

    Journal of Pediatric Endocrinology & Metabolism : JPEM
    |November 13, 2014
    PubMed

    Insights

    Recombinant human growth hormone (rhGH) therapy reduced cortisol levels, especially in children with multiple pituitary hormone deficiencies (MPHD). Monitoring the hypothalamic-pituitary-adrenal (HPA) axis is crucial during rhGH treatment.

    Area of Science:

    • Pediatric Endocrinology
    • Endocrinology
    • Hormone Therapy

    Background:

    • Growth hormone deficiency (GHD) affects children's growth and development.
    • The hypothalamic-pituitary-adrenal (HPA) axis regulates stress response and metabolism.
    • Recombinant human growth hormone (rhGH) therapy is a standard treatment for GHD.

    Purpose of the Study:

    • To investigate the impact of rhGH therapy on the HPA axis in children with GHD.
    • To assess changes in cortisol levels during rhGH treatment.
    • To compare HPA axis response in children with isolated GHD versus multiple pituitary hormone deficiencies.

    Main Methods:

    • A multicenter, retrospective study of 72 children with GHD treated with rhGH for 6 months.
    • Patients were categorized into isolated GHD (IGHD) and multiple pituitary hormone deficiencies (MPHD) groups.
    • HPA axis and hormone levels were evaluated at baseline and every 3 months.

    Main Results:

    • Cortisol levels significantly decreased in MPHD patients receiving rhGH therapy.
    • A subset of MPHD patients (10/52) exhibited low cortisol levels post-therapy.
    • Cortisol levels also decreased in the IGHD group but remained within the normal range.

    Conclusions:

    • rhGH therapy is associated with reduced cortisol levels, particularly in children with MPHD.
    • Close monitoring of the HPA axis is recommended during rhGH therapy.
    • Further research may explore the long-term implications of these HPA axis changes.
    Abstract

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